Exam 1 Review

A nurse is providing teaching to a newly licensed nurse about metoclopramide. Which of these is contraindicated to this medication? Hyperthyroidism Intestinal obstruction Glaucoma Low blood pressure

Intestinal obstruction It increases GI motility and promotes gastric emptying. Contraindicated in obstruction or perforation.

A nurse is administering a medication to a client. The nurse should identify that which of these factors facilitates effective passage of the medication across the CELL MEMBRANES? Protein-binding ability Lipid solubility Hepatic metabolism Slow dissolution

Lipid solubility

A nurse is teaching a client who has a new prescription for phenytoin. The nurse should inform the client that abrupt withdrawal of phenytoin can cause which adverse effect? Status epilepticus Bleeding gums Disorientation Severe nausea

Status epilepticus

A nurse is administering subcutaneous epinephrine for a client who is experiencing anaphylaxis. The nurse should monitor the client for which adverse effect? Hypotension Hyperthermia Hypoglycemia Tachycardia

Tachycardia Adverse effects of epi, an adrenergic agonist, can include tachycardia and dysrhythmias due to cardiac stimulation.

A nurse is teaching about levodopa with a family member of a client who has Parkinson's disease. Which of the following pieces of information should the nurse include? "A full therapeutic response may take several months to happen." "The medication should be taken with high-protein foods." "A full therapeutic response may cause vivid dreams." "The medication is given at the onset of mild symptoms."

"A full therapeutic response may take several months to happen."

A nurse asks the client, "What's the difference between analgesia an anesthesia?" Which of the following responses should the nurse make? "Analgesics can cause lack of sensation." "Anesthesia is specifically for eliminating pain perception." "Analgesics treat pain without causing sedation." "Anesthesia can cause loss of consciousness."

"Anesthesia can cause loss of consciousness."

A nurse is providing discharge teaching about lithium toxicity to a client who has a new prescription for lithium. Which of the following statements by the client indicates understanding? "I should take naproxen if I have a headache because aspirin can cause lithium toxicity." "I can develop lithium toxicity if I eat foods with lots of sodium." "I can develop lithium toxicity if I experience vomiting or diarrhea." "I may need to take a daily diuretic along with my lithium to prevent lithium toxicity."

"I can develop lithium toxicity if I experience vomiting or diarrhea." These can cause electrolyte imbalances. If sodium is depleted, lithium is retained by the kidneys since it is a salt, and the risk of lithium toxicity increases.

A nurse is providing teaching to a client who has a new prescription for a fentanyl transdermal patch. Which of the following statements by the client indicates understanding? "The patch will not cause constipation like the other pain medications do." "I will have to stop drinking grapefruit juice while using the patch." "I will place a heating pad over the patch to boost its effectiveness." "The patch will give me relief from my pain faster than pills can."

"I will have to stop drinking grapefruit juice while using the patch." Grapefruit can increase absorption of the med, raising the amount of fentanyl in the client's blood. It places the client at risk for CNS and respiratory depression.

A nurse is teaching about the adverse effects of morphine to a client with acute pain. Which should be included in the teaching? "You might notice that you see better in dim areas." "You should increase your fluid intake." "You should expect to have excessive urination." "You might experience difficulty sleeping."

"You should increase your fluid intake." Adverse effect includes constipation; encourage oral fluids to promote GI motility.

A nurse is providing teaching to parents of a school-aged child with asthma about medications for bronchospasm. Which of the following inhaled meds should the nurse instruct the parents to use to relieve an ACUTE asthma attack? Salmeterol Cromolyn Fluticasone Albuterol

Albuterol

A nurse is caring for a client who has a new diagnosis of rheumatoid arthritis. The nurse should anticipate a prescription from the provider for which med for daily management of RA? Celecoxib Prednisone Adalimumab Abatacept

Celecoxib NSAIDs should be initiated for new diagnosis of RA.

Nurse administering brimonidine eyedrops to a client with glaucoma. Which ocular effect is expected? Decreased intraocular pressure Blocked growth of new blood vessels Paralysis of accommodation Mydriasis

Decreased intraocular pressure

A nurse is teaching about a client with ADHD who is starting amphetamine/dextroamphetamine mixture. Which of the following should the nurse instruct the client to identify as an adverse effect and report to provider? Restlessness Insomnia Palpitations Weight gain

Palpitations Can be a sign of cardiovascular adverse reaction and requires immediate attention.

A nurse is preparing to administer medication to a preschooler. The nurse should use which of the following to calculate medication dosage for this client? BMI Height Weight Rule of 9s

Weight Children's doses are usually written in units of measure per body weight, like mg/kg.

A nurse is caring for a client who has multiple med allergies. During which of the following steps of the nursing process should the nurse identify client allergies? Planning Evaluation Assessment Implementation

Assessment

A nurse is caring for a client who is taking sulfasalazine twice daily for rheumatoid arthritis. Which of the following values should the nurse review prior to the administration of the medication? Respirations Serum creatinine level Blood pressure CBC

CBC Sulfasalazine can cause bone marrow suppression, which can lead to agranulocytosis, hemolytic anemia, and macrocytic anemia.

A nurse who is caring for a client who is experiencing an ACUTE gout attack. The nurse should anticipate a prescription from the provider for which med? Colchicine Allopurinol Probenecid Pegloticase

Colchicine Drug of choice for an acute gout attack; works within hours. Can also be used prophylactically.

A nurse is monitoring a client who is receiving phenytoin IV for the treatment of status epilepticus. Which of the following findings should the nurse identify as an adverse effect of the medication? Hypertension Cardiac dysrhythmias Gastric discomfort Tachycardia

Cardiac dysrhythmias

A nurse is caring for a client who is receiving sumatriptan for cluster headaches. Which of the following findings should the nurse expect as an adverse effect? Hypotension Tinnitus Urinary retention Chest pressure

Chest pressure About 50% of clients who take sumatriptan experience chest pressure and heaviness of the arms that are transient and resolve. If it persists, notify physician.

A nurse is caring for a client who is experiencing acute alcohol withdrawal. The nurse should expect to administer which of the following medications? Disulfiram Chlordiazepoxide Methadone Varenicline

Chlordiazepoxide Chlordiazepoxide is a benzodiazepine often used to facilitate withdrawal; it assists with decreasing withdrawal manifestations, stabilizing vital signs, and preventing seizures and delirium tremens.

A nurse is reviewing the medication administration record of a client who is receiving an opioid med for pain. Which of the following will the nurse clarify with the provider? Metoprolol Ondansetron Lorazepam Naloxone

Lorazepam Lorazepam can cause CNS depression which can result in respiratory depression and sedation when administered with an opioid.

A nurse is caring for a client who is experiencing an acute asthma exacerbation. Which of the following medications should the nurse identify as being contraindicated for this client? Dextromethorphan Montelukast Ciprofloxacin Propranolol

Propranolol It is a non-selective beta-blocker and will prevent the action of beta2-agonists such as albuterol.

A nurse is assessing a client who began taking clozapine 3 weeks ago. Which findings should the nurse report to the provider immediately? Tachypnea and tachycardia Abdominal pain and constipation Enuresis and polyuria Dry mouth and blurred vision

Tachypnea and tachycardia Greatest risk is the development of myocarditis, a potentially fatal adverse effect of clozapine, that typically occurs 30 days after starting the med. D/c the med and avoid using in the future.

A nurse is assessing a client who is receiving clozapine to treat schizophrenia. The nurse should identify an increase in which of the following parameters as an early indication of an adverse effect of this medication? Urine specific gravity Urine output Blood pressure Temperature

Temperature Antipsychotic medications such as clozapine can cause agranulocytosis, which is the depletion of WBCs. This increases the client's risk for infection. A fever is an early indication to check the client's WBC count to detect agranulocytosis.